Journal of Clinical Engineering
April/June 2009, Volume 34, Issue 2, pp 99-102
Misdiagnosis of Carpal Tunnel Syndrome: A Systematic Misclassification or Error of Omission
MC Mireles, PhD, MPH, Community Medical Foundation for Patient Safety, Bellaire, TX
JA Miller, PhD, Community Medical Foundation for Patient Safety, Bellaire, TX
WC Paske, PhD, Red Oak Instruments, LLC, Katy, TX
Carpal tunnel syndrome (CTS) screening is problematic and often inaccurate. Surgical treatment for CTS, involving open-hand or endoscopic ligament releases accounts for 11% of all surgeries performed. Of these surgeries, about 50% fail. We compared the sensitivity and specificity of CTS screening tests. Using multiple screening tests is believed to increase accuracy, but the results showed specificity decreases to 48% or less. Most misdiagnoses were false negatives, suggesting that many surgical treatments were unnecessary. This systematic misclassification based on imprecise screening tests is also an error of omission when physicians have only these tests to use. A new screening method and test are considered.